Systolic thickening fraction of inerventricular septum as a predictor of superresponse to cardiac resyncronisation therapy - concept of a helical ventriсular band

Abstract

Aim: to assess morpho-functional properties of left ventricle (LV) in patients with superresponse (SR) to CRT using the helical ventriсular band concept (HVB).Materials and methods: 56 patients were examined (mean age 54.0±9.9 years) at baseline and during follow-up visit: 48.8±25.6 months. Patients were divided into groups: I group (n=34) with decrease of LV end-systolic volume (ESV) ≥30% (superresponders) and II group (n=22) - decrease of LV ESV ˂30% (nonsuperresponders).Results: apical loop descendens segment (DS) and ascendens segment (AS) of HVB were evaluated according to the concept of F. Torrent-Guasp et al. According to the logistic regression mechanical interventricular delay (MID) (OR 1.072, 95% CI 1.017-1.131; p=0.01) and systolic thickening fraction (STF) of interventricular septum (IVS) DS (OR 0.944, 95% CI 0.895 - 0.995; p = 0.033) had an independent relationship with CRT SR. According to the ROC analysis the sensitivity and specificity of this model were 72.7% and 66.7% (AUC=0.769; р=0.001). AS STF of IVS was higher in SR (22.5 [0.0;40.0]% и 0.0 [0.0;25.0]%; р=0.005). The survival rate in group I was 85.1%, in group II was 63.6% (Log-Rank test p=0.019).Conclusion: SR is associated with a higher AS STF of IVS, higher MID, also with a higher survival rate.